By September 4, a total of 607 people in the Plovdiv region were reported as infected with the hepatitis A virus. Four hundred seventy-seven of them came from the Stolipinovo and Sheker Mahala Roma quarters of Plovdiv. Most of the infected were Roma children and teenagers, acording to Plovdiv Regional Inspectorate for Protection and Control of Public Health (PRIPCPH) data.

Immunisation in the affected areas will probably start only in the last 10 days of September, even though vaccinations for about 12 400 Plovdiv children were provided on August 9. The Health Ministry has started a public procedure to choose an immunisation supplier.

The procedure would end soon after September 11, the ministry said. Hepatitis has a 20- to 50-day incubation period. It takes about 15-20 days for a person to rebuild his or her immunity after immunisation. This means that actual results would only take effect in mid-October, the Health Ministry said.

The hepatitis infection broke out in July. Director of the PRIPCPH, doctor Ani Eginlian, declared it an epidemic on August 30.

Scores of people have been coming to the Plovdiv hospital of Sveti Georgi (Saint George) and hospitals in the surrounding towns every day. On September 4, 29 were registered. The week of August 20, 258 people in the whole country became infected, as opposed to 169 in the previous week, the Health Ministry said. Eighty-three of the 258 came from Stolipinovo.

On September 7 or 8, representatives of the Iztok and Sever municipalities of Plovdiv (where Stolipinovo and Sheker Mahala are), the PRIPCPH, surrounding villages and the Plovdiv branch of the Bulgarian Red Cross (BRCP) were to meet to co-ordinate their efforts to prevent a further outbreak of the disease, a BRCP official told The Sofia Echo. At the moment, things were still at a stage when precise needs were being evaluated, the official said.

All parents of Roma children have otherwise received invitations for immunisation, the head of the Health Ministry department for supervising infectious diseases, Angel Kunchev, told Bulgarian news agency BTA. Children whose parents did not agree to vaccinations would not be vaccinated, he said.

Immunisation has been dogged by doctor protests also. Doctors were not refusing to vaccinate, according to an August 31 declaration sent by doctors to the Health Ministry, Plovdiv municipal institutions and state institutions. Rather, they wanted precise immunisation schedules, corresponding payment arrangements and separate immunisation rooms to prevent infecting other patients, BTA said.

The Health Ministry provided the schedules and was arranging additional medical teams to aid the vaccination process. The teams would come from the ministry, PRIPCPH and neighbouring regions.

On September 1, the PBRC committee gave 150kg of washing powder to 100 families in Plovdiv's Stolipinovo and Sheker Mahala.

The donation came from the Italian and Swiss Red Crosses. The Labour and Social Policy Ministry also gave about 8500 packs of soap and wet wipes to Stolipinovo residents on August 9. These cost about 10 000 leva, BTA said.

The Cabinet decided to give an additional one million leva to sanitise Stolipinovo, Health Minister Radoslav Gaidarski said on August 29. Stolipinovo had not been cleaned up for years. The clearing of about 40 tons of refuse, which at places rose a metre high, only started on August 30, but refuse was now being cleared regularly. Shops and cafes in the two Roma quarters were also to be regularly inspected, as were all affected areas in the region.

The areas between housing blocks in Stolipinovo should be drained and asphalted, and their inhabitants should be brought out of there, Gaidarski said. The municipality recently started demolishing illegal wood and tin makeshift Roma houses as a measure to prevent infection.

The actual problem, however, was not illegal dwellings, but lack of a sewerage system and running water, Stolipinovo inhabitants told weekly paper Kapital. Refuse water had, so far, been poured into the basements of surrounding housing complexes, and clean running water would sometimes not reach beyond the second floor of housing complexes.

Health measures would not be enough to fight hepatitis, Gadiarski said. Unless living conditions in the Roma quarters changed, the epidemic would repeat itself in five years, Kunchev told BTA.